Astigmatism, a common vision problem caused by an irregularly shaped cornea, can lead to blurry vision and other visual disturbances. Fortunately, advances in medical technology have made laser eye surgery a viable option for many individuals seeking a permanent solution to their vision woes. In this post, we’ll delve into the world of laser eye surgery for astigmatism, examining its pros and cons and providing insights into various aspects of the procedure.

Understanding Astigmatism and Laser Eye Surgery

Astigmatism occurs when the cornea, the clear front cover of the eye, has an irregular shape, causing blurry or distorted vision. Laser eye surgery, including LASIK (Laser-Assisted In Situ Keratomileusis), Photorefractive Keratectomy (PRK), and Small Incision Lenticule Extraction (SMILE), are popular refractive surgeries aimed at correcting this refractive error.

Types of Laser Eye Surgery for Astigmatism

For those considering laser eye surgery to correct astigmatism, understanding the different types available is crucial. Each type has its unique approach and suitability depending on the patient’s specific condition and eye structure.

Laser Eye Surgery for Astigmatism Pros And Cons assessment melbourne1. LASIK (Laser-Assisted In Situ Keratomileusis)

  • Description: The most popular type of refractive surgery. LASIK involves creating a thin flap in the cornea using a femtosecond laser or a microkeratome. The surgeon then uses an excimer laser to reshape the underlying corneal tissue.
  • Suitability: Ideal for patients with a moderate degree of refractive error and sufficient corneal thickness.
  • Recovery: Rapid recovery, with most patients experiencing improved vision within 24 hours.

2. PRK (Photorefractive Keratectomy)

  • Description: One of the first types of laser eye surgeries developed, PRK involves the removal of the cornea’s surface layer to allow reshaping by the excimer laser.
  • Suitability: Suitable for patients with thin corneas or certain corneal surface irregularities.
  • Recovery: Longer recovery time compared to LASIK, as the cornea needs time to heal and regenerate the surface layer.

3. LASEK (Laser-Assisted Subepithelial Keratectomy)

  • Description: Similar to PRK, but instead of removing the surface layer of the cornea, it’s loosened and pushed aside before reshaping the cornea with the laser.
  • Suitability: A good option for patients with thin corneas who might not be suitable for LASIK.
  • Recovery: Recovery time is similar to PRK, with a gradual improvement in vision over several days to weeks.

4. SMILE (Small Incision Lenticule Extraction)

  • Description: A minimally invasive procedure where a small, lens-shaped bit of corneal tissue (lenticule) is created inside the cornea and then removed through a small incision, reshaping the cornea.
  • Suitability: Recommended for patients with higher degrees of myopia, astigmatism, and a desire for a flapless, minimally invasive procedure.
  • Recovery: Recovery is quick, with most patients reporting minimal discomfort and rapid visual recovery.

5. Refractive Lens Exchange (RLE)

  • Description: Involves replacing the eye’s natural lens with an artificial intraocular lens. This procedure is similar to cataract surgery but is performed primarily for refractive purposes.
  • Suitability: Best for patients with presbyopia or high degrees of refractive error not suitable for corneal-based surgeries.
  • Recovery: Recovery may take a few weeks, with gradual vision stabilisation.

Factors to Consider When Choosing a Procedure

  • Corneal Thickness: Patients with thin corneas may be better candidates for PRK or LASEK.
  • Degree of Astigmatism: Higher degrees of astigmatism might require specific procedures like SMILE or RLE.
  • Lifestyle Considerations: Occupations or hobbies that pose a risk of eye injury might make flapless procedures like SMILE more appealing.
  • Age and Eye Health: Older patients with signs of cataracts may benefit more from RLE.

Pros of Laser Eye Surgery for Astigmatism

  1. Improved Vision: The most significant benefit is the potential for dramatically improved vision. Many patients report achieving 20/20 vision or better after the procedure.
  2. Quick Recovery: Most patients experience rapid recovery. While full healing takes time, many can resume normal activities, including driving, within a few days to a week.
  3. No More Glasses or Contact Lenses: For many, the ability to ditch glasses or contact lenses is a life-changing experience, offering newfound freedom and convenience.
  4. Long-Term Solution: While not all vision correction is guaranteed, many patients enjoy stable vision for years, making it a potentially permanent solution to refractive errors.
  5. Safety and Efficacy: When performed by an appropriately qualified health practitioner, laser eye surgery is generally considered a safe procedure.

Cons of Laser Eye Surgery for Astigmatism

  1. Invasive Procedure Carries Risks: As with any surgical or invasive procedure, there are risks involved, such as the potential for surgical complications, infection, and in rare cases, vision loss.
  2. Dry Eyes and Other Side Effects: Some patients experience dry eyes, glare, halos, or double vision post-surgery, although these often resolve within a few weeks to months.
  3. Not Suitable for Everyone: Conditions like thin corneas, certain medical conditions, or severe refractive errors can make some individuals ineligible for surgery.
  4. Potential for Over or Under Correcting: There’s a chance that the surgery may not produce perfect vision, requiring additional procedures or continued use of glasses for certain activities.
  5. Cost and Insurance Considerations: Laser eye surgery is an elective procedure and often not covered by health insurance, making it a significant financial decision.

How Does Laser Eye Surgery Work?

Laser eye surgery for astigmatism involves precise and controlled removal or reshaping of corneal tissue to correct the uneven curvature that characterises astigmatism. Here’s a closer look at the process:

  • Pre-Surgical Assessment: Before the surgery, an eye doctor conducts a thorough eye exam to determine the exact nature and extent of the astigmatism. This assessment often includes mapping the cornea’s surface and measuring its thickness and overall health.
  • Type of Laser Used: Two main types of lasers are used in these surgeries:
  • Excimer Laser: Used in LASIK and PRK, this laser precisely removes the microscopic layers of the cornea to reshape it.
  • Femtosecond Laser: Used in SMILE and some types of LASIK, this laser creates a thin, circular piece of corneal tissue that is then removed.

The Surgical Procedure:

  • Creating the Flap (LASIK): In LASIK surgery, a thin flap is created on the cornea’s surface using a femtosecond laser or a microkeratome blade. This flap is lifted to expose the underlying corneal tissue.
  • Reshaping the Cornea: The excimer laser is then used to precisely reshape the cornea based on the pre-surgery measurements. This is the step where the astigmatism correction occurs.
  • Flap Re-positioning (LASIK): After the cornea is reshaped, the flap is laid back in place where it heals naturally without the need for stitches.
  1. Laser Eye Surgery for Astigmatism Pros and Cons consult melbourneProcedure Duration: The actual laser treatment usually takes less than a minute per eye, although the entire procedure, including preparation and post-op immediate care, might take around 30 minutes.
  2. Numbing Eye Drops: Throughout the surgery, numbing eye drops are used to ensure patient comfort. Most patients report little to no pain during the procedure.
  3. Post-Operative Care: Immediately after the surgery, patients often experience blurry vision and light sensitivity. These symptoms typically improve significantly within the first 24 hours.

Recovery and Post-Surgery Care

Recovery from laser eye surgery is relatively quick, but it requires careful attention:

  • Rest and Protect Your Eyes: It’s crucial to rest your eyes and protect them from bright lights and physical strain in the first few days post-surgery.
  • Use of Eye Drops: Anti-inflammatory and antibiotic eye drops are prescribed to aid in the healing process and prevent infections.
  • Avoid Strenuous Activities: For at least a week after the surgery, avoid any strenuous activities that might strain the eyes or increase the risk of injury.
  • Regular Follow-up Exams: Attend all follow-up appointments to monitor the healing process and allow for any necessary adjustments or treatments.

Choosing the Right Procedure and Surgeon

  1. LASIK vs PRK vs SMILE: Each type of refractive surgery has its advantages. LASIK is popular due to its quick recovery, while PRK is often recommended for patients with thin corneas. SMILE is a newer technique that may offer benefits in certain cases.
  2. Consult an Eye Surgeon: An in-depth consultation with an eye surgeon is essential to determine the most appropriate treatment for your specific condition.
  3. Consider Experience and Credentials: Choose a surgeon with extensive experience in performing laser eye surgeries, and check their credentials to ensure they are appropriately qualified.

Frequently Asked Questions (FAQs) About Laser Eye Surgery for Astigmatism

 

 

Laser eye surgery is a significant decision, and it’s natural to have many questions. Below are some of the most frequently asked questions about laser eye surgery for astigmatism, providing further insights into what to expect and consider:

Is Laser Eye Surgery for Astigmatism Permanent?

  • Answer: The results of laser eye surgery for astigmatism are intended to be permanent. However, it’s important to note that the eye can still undergo natural changes over time, which might affect vision. Some patients may require a follow-up procedure later in life.

How Much Does Laser Eye Surgery Cost?

  • Answer: The cost of laser eye surgery varies depending on the type of procedure, the technology used, and the surgeon’s experience. In Australia, prices can range widely, and it’s advisable to get detailed quotes from several clinics. Remember, this is usually an out-of-pocket expense as it’s considered an elective procedure.

What Are the Risks of Laser Eye Surgery?

  • Answer: While laser eye surgery is generally safe, risks include dry eyes, infection, under or overcorrection, and, in rare cases, loss of vision. Choosing a qualified and experienced surgeon can help minimise these risks.

How Long Does Recovery Take?

  • Answer: Recovery times can vary. Most patients notice a significant improvement in vision within 24 hours, but it can take several weeks to months for vision to fully stabilise. Following your surgeon’s aftercare instructions is crucial for optimal recovery.

Can I Have Laser Eye Surgery If I Have Dry Eyes?

  • Answer: Severe dry eyes can affect your eligibility for laser eye surgery. Your eye doctor will assess the severity of your condition and advise if treatment for dry eyes is needed before surgery.

What’s the Difference Between LASIK, PRK, and SMILE?

  • Answer: LASIK involves creating a flap in the cornea, PRK reshapes the surface of the cornea without a flap, and SMILE involves creating a small incision and removing a piece of corneal tissue. Each has its advantages and suitability depending on individual cases.

How Do I Know If I’m a Good Candidate for Laser Eye Surgery?

  • Answer: Good candidates typically have a stable prescription for at least 12 months, are over 18 years old, and have healthy eyes with no significant eye diseases. Your eye doctor can determine your eligibility through a comprehensive eye examination.

Will I Need Glasses After Laser Eye Surgery?

  • Answer: The goal of laser eye surgery is to reduce or eliminate the need for glasses or contact lenses. However, some patients may still need them for certain activities, especially as they age.

Can Both Eyes Be Treated at the Same Time?

How Should I Prepare for Laser Eye Surgery?

  • Answer: Preparation includes stopping the use of contact lenses for a period as advised by your surgeon, arranging for transportation post-surgery, and avoiding makeup or lotions on the day of the procedure.

Can I Play Sports After Laser Eye Surgery?

  • Answer: You should avoid contact sports and activities that pose a risk to your eyes for several weeks post-surgery. Your surgeon will provide specific guidelines based on your recovery.

Laser Eye Surgery for Astigmatism Pros And Cons risks melbourne

Are There Age Restrictions for Laser Eye Surgery?

  • Answer: While there’s no strict upper age limit, patients typically need to be at least 18 years old. Suitability for older patients depends on overall eye health and the presence of any age-related eye conditions.

What Happens During a Consultation for Laser Eye Surgery?

  • Answer: A consultation involves a thorough examination of your eyes, a discussion of your vision problems, and an evaluation of your suitability for surgery. It’s also an opportunity to ask questions and understand the risks and benefits.

Conclusion

Laser eye surgery for astigmatism offers the promise of improved vision and a glasses-free lifestyle, but it’s important to weigh the pros and cons carefully. It’s a safe and effective procedure for many, but not without risks and limitations. Consultation with a qualified eye health professional is essential to make an informed decision tailored to your individual needs and circumstances.

Call us today at (03) 9000 0389 to schedule your consultation and find out if laser eye surgery for astigmatism is right for you. With our experienced surgeons and cutting-edge technology, we are here to help you restore clear vision.

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

References 

  1. https://www.mayoclinic.org/tests-procedures/lasik-eye-surgery/in-depth/lasik-surgery/art-20045751
  2. https://www.medicalnewstoday.com/articles/laser-eye-surgery
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